The effects of bilateral alternating out-of-phase vibrations were studied in 10 normal healthy subjects and five asthmatic patients. The second or third intercostal spaces were vibrated during expiration, and the seventh to ninth intercostal spaces were vibrated during inspiration. Most subjects sensed breathlessness during such vibrations, and 100 Hz was most effective. The degree of breathlessness correlated positively with increased respiratory rate. Respiratory rate increased from 14.1 +/- 3.78 (mean +/- SD) to 22.3 +/- 7.14 breaths/min (P less than 0.05) during relatively severe breathlessness and to 20.39 +/- 5.66 breaths/min (P less than 0.05) during less uncomfortable sensation. Slight or negligible breathlessness induced no significant increase in rate (15.33 +/- 4.19 breaths/min). All asthma patients described the sensations during vibration as similar to those during asthma attacks, and their respiratory rates increased 20.7 +/- 11.03% during 100 Hz vibration (P less than 0.01). It is suggested that the uncomfortable sensation of breathlessness may be induced by muscle spindles in the intercostal muscles being activated out of phase with the respiratory cycle. The central mechanism that receives the intercostal afferents may have a certain gate that operates in relation to the sensation of breathlessness.

We studied the l-type isoproterenol inhalation therapy for patients with severe asthmatic attacks who were admitted at the Department of Allergy of National Children’s Hospital from 1981 to 1991. One hour after l-type isoproterenol inhalation therapy, statistically significant effects were noted with regard to the asthmatic status. Moreover, no side effect was found amoung the subjects. From these data, l-type isoproterenol inhalation therapy is thought to be effective for severe asthmatic attacks.

The incidence of latex-induced allergy has been reported to be increasing in Europe and the US but not in Japan. We thus measured latex-specific IgE antibodies and latex-specific IgG antibodies in sera from 196 atopic children with low serum IgE levels (under 1,000 U/ml; group 1), 108 atopic children with high serum IgE levels (over 1,000 U/ml; group 2) and 601 hospital employees (group 3). Atopic children were diagnosed as having asthma, atopic dermatitis and/or food intolerance. One out of group 1 (0.5%) and 11 out of group 2 (10.2%) were found to have latex-specific IgE by radioallergosorbent assay (RAST), and 7 were further found to be positive for latex antigen by skin test. Fifty-five percent of group 1, 65% of group 2 and 9.7% of group 3 were found to have latex-specific IgG over 100 units/ml by enzyme linked immunosorbent assay (ELISA). Prior to our diagnosis most of the children and employees did not realize they were allergic to latex. These data suggest that caution should be taken regarding latex allergy when atopic children have to be operated upon as atopic children tend to be sensitized to the latex antigen after even minimal contact with latex products.

These results confirm that mite allergens accumulate rapidly in toys to form a potentially important source of allergens and that washing toys with a chemical detergent is effective in the reduction of allergens.

We measured changes in histamine and tryptase levels in fluid of children with atopic dermatitis using skin chamber methods and evaluated the correlation with clinical symptoms. Skin chambers were applied to forearm skin which had been scratched with a needle, and an extract of Dermatophagoides farinae (mite antigen) at 50 μg/ml in saline was added through 0.3-μm filters as a challenge. We measured the concentrations of tryptase and histamine 2, 6, 12, and 24 h after challenge. The skin chamber test was done before and after hospitalization therapy or beach camp therapy. We also tested patients with atopic dermatitis of varying severity, asthmatic patients without dermatitis, and normal volunteers. The histamine levels dramatically increased 24 h after challenge with mite antigen in patients with severe atopic dermatitis, whereas this was not observed in patients with mild atopic dermatitis or asthma and in normal volunteers. The levels of histamine in the chambers 24 h after challenge decreased along with improvement of skin condition after various kinds of treatment and beach camp therapy. These results indicate that the skin chamber test will be a useful objective tool to evaluate the skin conditions of patients with atopic dermatitis. The increase of histamine level was not accompanied by an increase in tryptase level, suggesting the importance of basophil activation in this disease.